Gynaecological cancer patients_ expectations, understandings and experiences of high dose rate brachytherapy treatment

Abstract

Aim: The brachytherapy procedure is an invasive procedure, as part of radiation therapy treatment process. The aim of this study was to establish the gynaecological cancer patients_ expectations, understandings and experiences of high dose-rate (HDR) brachytherapy treatment. Method: Qualitative research design with a descriptive phenomenology research methodology approach was adopted to get insights into the lived expectations, experiences and understandings of patient participants. Semi-structured interviews were conducted of ten participants with purposive sampling method, until data saturation was reached. Findings: Themes that emerged from the cyclical interpretation and analysis are: Treatmentexpectation, Status of illness and acknowledgement thereof; The familiar vs. “I don_t have any clue”_ “We_ll see for ourselves what is happening”; Treatment-experience, Brachytherapy treatment process and Physical experience; Post-treatment understanding, Patients_ understanding and description of Brachytherapy; Patient preferences: Improvement vs. contentment; Desires to normalcy vs. sense of disappointment; Off-spin of treatment processes and procedures; and overarching themes included Control vs. Sense of being lost; Gap in communication; silent voice of the patient; preferences for information needs; submissive patient; the role of the healthcare provider), which were the golden threads throughout the findings. Discussion: The structure of the discussion was shaped along a proposed framework which illustrates the influence of numerous factors, Quality of care and patient-centred care; Brachytherapy treatment process; the healthcare provider; and Cancer staging and treatment processes impacting on the patients_ life-world whilst undergoing brachytherapy procedure. The framework takes the findings to a deeper level of meaning of the patients_ life-world: Expectation, the limited space for making sense of the treatment and the illness status; Experience, the flux between feeling hope and hopelessness; understanding, shaping of understandings and making meaning, optimism as a coping strategy whilst in transit of the care vi continuum, fragmented interactions and communication processes; supportive provider and cooperative patient. Conclusion: It is not so much so about the patient_s desire for information, preparedness and undergoing of the procedure. Rather the focus shifts towards the significant role of brachytherapy as a treatment intervention regarding their cancer care to normalcy.